自动乳腺全容积成像与钼靶在BI-RADS-US 4类小肿块良恶性诊断中的应用

目的：探讨自动乳腺全容积成像(automated breast volume scanner，ABVS)技术与X线钼靶(mammography， MG)对超声乳腺影像和数据报告系统(breast imaging reporting and data system ultrasound，BI-RA DS-US)4类乳腺小肿块良 恶性诊断的应用价值。方法：利用ABVS及MG对常规超声(ultrasound，US)诊断为BI-RA DS-US 4类的103 例患者共109枚 小肿块进行扫查，以术后病理结果作为金标准，分析两者与US联合应用的诊断效能。结果：US，US联合MG，US联 合ABVS，US与ABVS及MG三者联合诊断的敏感性分别为85.5%，86.8%，94.7%，96.0%；特异性分别为66.7%，69.7%， 81.8%，84.9%；准确率分别为79.8%，81.6%，90.8%，92.7%；受试者工作特征(receiver operating characteristic，ROC)曲线 的曲线下面积(area under curve，AUC)分别为0.76，0.78，0.88，0.90。US联合ABVS诊断准确率及AUC均高于US及US联 合MG(P<0.05)，特异性及敏感性差异无统计学意义(P>0.05)。US联合ABVS，US与ABVS及MG三者联合组间比较，其 敏感性、特异性、准确性和AUC差异均无统计学意义(P>0.05)。结论：对于BI-RA DS-US 4类乳腺小肿块，ABVS联合US 能提高其诊断效能，且优于US联合MG。

Application of automated breast volume scanner and mammography in differentiation of small breast lesions with BI-RADS-US 4

Objective: To evaluate the value of automatic breast volume scanner (ABVS) and mammography (MG) in differential diagnosis for small breast lesions with breast imaging reporting and data system ultrasound (BI-RADS-US) 4. Methods: ABVS and MG were performed for 103 patients with 109 breast lesions, which were classified as BI-RADS-US 4 by conventional ultrasound (US). Postoperative pathological diagnosis served as gold standard. The diagnostic efficacy for US, US combined with MG, US combined with ABVS and the combination of three methods were compared. Results: The sensitivity of US, US combined with MG, US combined with ABVS and the combination of three methods were 85.5%, 86.8%, 94.7% and 96.0%, respectively. The specificity for them were 66.7%, 69.7%, 81.8% and 84.9%, respectively. The accuracy for them were 79.8%, 81.6%, 90.8% and 92.7%, respectively. The area under the receiver operating characteristic (ROC) curve (AUC) for them were 0.76, 0.78, 0.88 and 0.90, respectively. The accuracy and AUC for US combined with ABVS in differential diagnosis of BI-RADS-US 4 small breast lesions were significantly higher than those of US and US combined with MG (P<0.05). There was no significant difference in sensitivity and specificity among these 3 groups (P>0.05). No significant difference was found in sensitivity, specificity, accuracy, and AUC between US combined with ABVS and the combination of three methods (P>0.05). Conclusion: Combination of US with ABVS can improve the diagnostic efficacy of conventional US in differential diagnosis for BI-RADS-US 4 small breast lesions, and it is superior to US combined with MG.